What are hearing aids

Hearing aids

1. The most important things in a nutshell

Hearing aids are among the aids. Statutory health insurance reimburses the cost of a hearing aid up to a certain fixed amount. In addition to the statutory health insurance, other cost bearers can also pay for the required hearing aid, but in some cases an additional payment is due.

2. What is considered a hearing aid

According to the Federal Joint Committee, the following hearing aids, which can be recognized by the insurance companies, are considered technical aids that are used in the case of functional disorders of the ear:

  • Hearing aids (air conduction devices and bone conduction devices) and accessories,
  • Tinnitus devices, also combined tinnitus and hearing aids, so-called tinnitus instruments, and
  • Transmission systems.

3. Hearing aids

The goal of hearing aid supply is

  • to compensate for a hearing deficit as much as possible so that the person affected understands something again, if possible, in the presence of ambient noises and in larger groups of people,
  • to improve spatial hearing as much as possible through a two-ear supply and
  • eliminate or mitigate the effects of communication impairment throughout daily life.

There are a number of hearing aids, but now they have to be supplied with digital systems. These must have at least 4-channel signal processing, 3 hearing programs, noise and feedback suppression and an amplification power of up to 75 decibels (dB). In the case of hearing impairment bordering on deafness, the amplification power must be at least 75 dB.

A distinction is made between BTE devices (behind the ear) and ITE hearing aids (in the ear). A special supply are hearing glasses. Glasses and hearing aids are combined. As a rule, they are used in cases of severe hearing loss or deafness on one side.

Hearing aid acousticians provide information on the individual hearing aids. Those insured with substitute insurance companies can choose whether they want advice from a hearing aid acoustician or an ENT doctor when choosing a hearing aid. Patients can inquire about which medical practices are participating from their health insurance company.

3.1. requirements

A hearing aid can be prescribed under the following conditions:

  • Examination, anamnesis and tone and speech audiometric confirmation by an ENT doctor (prescription).
  • Bilateral or unilateral hearing loss.
  • The patient (or caregiver) must be able to use the hearing aid.
  • The patient must want to wear the hearing aid.

Bone conduction hearing aids can only be prescribed if the common hearing aids (air conduction hearing aids) do not achieve the goal. This is only the case with certain diseases, e.g. malformations in the ear.

A Re-regulation can usually only take place after 6 years, in children and adolescents after 5 years. If a hearing aid has to be replaced earlier, special justification is required.

3.2. Fixed amounts and scope of services of the health insurance companies

Fixed amount means that the health insurance company only pays this amount. Anyone who opts for a more expensive supply has to Pay additional costs yourself. However, the fixed amounts of the cash registers differ. The minimum fixed amounts are as follows:

  • Fixed price for 1 hearing aid for adults with hearing loss: € 784.94
    Fixed amount for the 2nd hearing aid with both ears (20% less): € 627.95
  • Fixed amount for hearing loss bordering on deafness: € 841.94
    Fixed amount for the 2nd hearing aid with both ears (20% less): € 673.35
  • If applicable, ear molds (holder): € 33.50

 

The following services must be provided for these fixed amounts:

  • Anamnesis, recording of the social situation
  • Ear examination
  • Sound and speech hearing measurement
  • Preselection of suitable hearing aids
  • Presetting of the selected devices according to the individual hearing loss
  • Comparative hearing aid fitting
  • Tolerance test
  • Instruction in the operation and handling
  • Fine tuning
  • Documentation by the hearing aid acoustician, including the measurement results in the background noise
  • Prescription accounting

4. Tinnitus devices (tinnitus maskers, noisers)

The aim of the tinnitus device supply is that the subjective tinnitus is no longer perceived as disturbing.

 

Requirements for the assumption of costs by the health insurance company:

  • Chronic tinnitus was diagnosed.
  • Prescription by the doctor.
  • The cost estimate must be approved in advance by the health insurance company.
  • For combination devices (tinnitus hearing aid, tinnitus instrument), the provisions for hearing aids apply.
  • If a hearing loss was diagnosed at the same time, it must first be improved with a hearing aid. Tinnitus devices may only be prescribed if this does not sufficiently relieve the tinnitus.

 

The health insurance companies pay the following fixed amounts (see explanation above) per ear:

  • Tinnitus device: € 317.45
  • Attachable tinnitus device: € 158.34
  • Tinnitus hearing aid: € 515.42
  • If applicable, ear molds (holder): € 33.50

4.1. Practical tip

The tinnitus care can be claimed in the tax return as an extraordinary burden.

5. Transmission systems

The aim of a transmission system in addition to the hearing aid is to improve the useful sound or noise ratio so that general basic needs of daily life can be satisfied. The aim is, for example, to promote the language development of children in daycare or school or to improve language comprehension (at any age) if this is not sufficiently successful with hearing aids.

6. Assumption of costs and co-payments

6.1. Health insurance providers

The health insurance companies cover the costs at least up to the legally stipulated fixed amount, some health insurance companies also pay more. The prerequisite is that a medical diagnosis is available when the first prescription is given and when there is a new clinical picture.

The doctor prescribes the aid on the form of the ear doctor's prescription for a hearing aid, also known as sample 15. In order for the health insurance to cover the costs, it must be redeemed within 28 days of being issued.

The additional payment for people aged 18 and over is 10% of the fixed amount, but at least € 5 and a maximum of € 10. In practice, this always amounts to an additional payment of € 10 - per device. In the case of two-ear care, the additional payment is therefore € 20.

Batteries are only reimbursed for insured persons up to their 18th birthday.

6.2. Cost bearers, pension insurance providers and integration offices

Pension insurance institutions and integration offices make a contribution to the costs that are above the fixed amount of the health insurance company if the normal compensation for hearing is not sufficient. There must be an additional job-related need.

6.3. Cost bearer accident insurance carrier

The accident insurance institutions cover the costs for the hearing aid and for the batteries, regardless of age, if the hearing loss was caused by an accident at work, commuting or an occupational disease.

7. Policy

The Federal Joint Committee has drawn up the so-called Medical Aids Directive for the regulation of medical aids. Sections 18–31 deal with hearing aids. Download the guideline at www.g-ba.de/informationen/linien/13/.

8. Who can help?

Health insurance, accident insurance, integration offices, employment agency, pension insurance.

The list of resources of the National Association of Statutory Health Insurance Funds (§ 139 SGB V), which can be researched online, contains all resources that are included in the list of services of the statutory health and long-term care insurance. More at https://hilfsmittel.gkv-spitzenverband.de/HimiWeb/home.action. Hearing aids are listed in product group 13.

9. Related links

Aids

Visual aids

Care aids

Remedies